Science and Technology in NYC

With obesity on the rise in New York City, it comes as no surprise that poorer neighborhoods, such as Harlem, would be affected most. Various factors contribute to the 25% adult and child obesity rate in Harlem, particularly beverage availability, choice and consumption.

In comparison to Harlem, the Upper East Side has a 7 % obesity rate – the lowest in all of New York City. Yet the Upper East Side is only a few steps away from Harlem. The disparity is due to a variety of environmental factors – income, resource availability, education, diet and more.

On 103^rd Street between Lexington and Park Avenue, there are three deli stores, one Chinese food restaurant, and one liquor store. All four stores carry alcohol and are conveniently located in between residential buildings. The three delis carry various chips, sodas and candy. One carries fruits and vegetables.

In contrast, there are no food stores on 79^th street between Lexington and Park Avenue. But there is a healthy alternative – Vitamin Shoppe.

Adding on to the lack of economic resources for Harlem residents, it doesn’t help that West and East Harlem combined has only 17 gyms, whereas the Upper East side, 60^th – 96^th St has fifty-seven gyms.

103^rd Street and 79^th Street are typical of Harlem and the Upper East Side, respectively. The Upper East Side has many more supermarkets and grocery stores, whereas Harlem is bombarded with corner stores, bodegas and fast food restaurants.

For the Harlem resident, the local store has limited choices – Red Bull, Tropicana orange juice, Top Pop and other soft drinks. When Tropicana costs $2.75 and Top Pop is only $1.25, consumers usually purchase the sugary soft drink.

“I can’t give my kids five dollars everyday to buy a protein shake,” says Darnell Delince, a Harlem resident, “but with two dollars you can buy two bags of chips and a soda. That keeps them happy.”

“The main problem with sugary soft drinks is calories,” said Dr. Marion Nestle, a professor of nutrition, “People who drink a lot of them tend to have worse diets, take in more calories, and weigh more than people who don’t.”

Even Harlem’s major supermarkets, such as C-Town, market sugary drinks to their customers. C-Town’s circular markets Hawaiian Punch for ninety-nine cents very heavily but fails to offer healthier alternatives. Hawaiian Punch contains less than 2% juice.

A popular supermarket on the Upper East Side  – D’Agostino – does not offer Hawaiian punch. Instead, their circulars contain advertisements for 3 Liters of Poland Spring water for ninety-nine cents.

Harlem residents are more likely to consume excessive amounts of unhealthy beverages, due to the different choices available to them in their local corner store.

Poor beverage choice and availability does not necessarily result in obesity. However, people who consume such beverages are less likely to make healthy diet choices.

According to Dr. Arlene Spark, “It’s totally unrealistic to expect to find anyone who is that diet conscious and health savvy who gets all the nutrients he needs in 450 calories less than he needs (to make room for the 450 he’d get from the soft drinks) who would also be drinking a lot of soda.” 

Assuming a person consumes 450 calories in soft drinks (3 cans) per day, is it possible to maintain a healthy weight?

If someone were to attempt this, Dr. Spark says, “He gains weight because of the extra calories he’s ingesting. Or he under-eats 450 calories to make room for the soda. That would mean he needs to get all the nutrients in 450 less calories, which can’t happen. Or the third possibility is he’ll get only a fraction of the nutrients he needs in a diet deficient in 450 calories in order to make room for the soda. That would results in nutrient deficiencies.”

However, few Harlem residents have the education necessary to make healthy decisions about beverage consumption.

“We are overweight,” says Delince, “but the city should educate us or at least let us know what drinks we shouldn’t drink.”

Dr. Joel Brind, a professor of biology disagrees. “I think the present city administration is going too far in regulating the sale of beverages–or trans fats, for that matter–in the city at large. This is way too intrusive on free enterprise, and it puts government in the role of deciding what is harmful and what is not.”

Community organizations are attempting to fight the obesity epidemic in Harlem. Mt. Sinai Hospital conducts cholesterol checks and hosts cardiac arrest fairs where residents can learn how to use defibrillators and CPR. The Community Healthcare Network offers Heart Health Program, a five week education program, specifically targeted for those with high blood pressure, high cholesterol and who are overweight or obese.

However, the best way to combat obesity due to improper consumption of sugary beverages still is, and always will be, water.

After all, “ NYC has a terrific-tasting water supply directly from the Catskill Mountains. It’s a lot less expensive than soda. And it contains fluoride – I happen to believe in its protective effects,” said Dr. Spark.

Asthma, an inflammatory lung disease, has hit the poor rural neighborhoods of New York City harshly in the past few years.  Roughly one fourth of the children in Harlem are affected by the disease, in which narrowed airways in the lungs evoke attacks of breathlessness and wheezing.

Due to the multi-factorial nature of asthma, scientists have been unable to find a cure and proper treatments.  Triggers such as mold, dust, pollen, and diesel fumes, along with obesity, smoking, and little medical access, all contribute to the fact that Harlem’s childhood asthma rates are amongst the highest in the nation.

“It is impossible to completely abolish all of the causes of asthma,” said Dr. George D. Thurston, a professor of environmental medicine at New York University.  “However, we, as citizens of New York City, must work together to control and diminish the tangible causes, such as diesel fumes and other air pollutions.”

Dr. Thurston hosted a Seminar at Brown University on Friday, October 2^nd, on Diesel Air Pollution and Asthma in New York City.  During his time as a researcher at New York University’s Langone Medical Center, he has found evidence indicating that living near to traffic is associated with increased respiratory problems in children.   Exposure to diesel vehicles is the most suspected causal agent in the associations between traffic and asthma.

Six out of the seven bus depots in New York City are located in Harlem.  Buses are the main source of diesel fuel emission.

“To get rid of this issue, we must either use cleaner diesel fuel or bring in hybrids, which burn less fuel,” explained Dr. Thurston, during a brief interview, as he was simultaneously shuffling through his notes for the big upcoming speech.

The problem here is transportation.  The city is surrounded by water; using these waterways for transportation purposes more efficiently would lessen the amount of diesel fuel in the air.  Instead of using buses and cars to transport goods into and out of Manhattan, companies should make use of the vast water ways, and create more water taxis, ferries, and freight ships.

Granted, diesel fume emission is a universal issue that needs to be moderated throughout every busy city.  Moreover, other issues that only affect low-income areas are what causes the asthma rates in places such as Harlem to skyrocket.

Cities scenes, filled with poor maintenance of multi-family housing, grocery stores, and restaurants and difficulties with sanitation and litter cause mice to be a common counterpart of the environment.

“Mice are silent predators for inner-city children.  These pests give off allergens that trigger asthma attacks, and it is just getting worse for those living in old apartment buildings that contain a lot of dust mixed with mouse urine,” said Limas Forte, the Healthy Homes Program Manager at WE ACT for Environmental Justice.

These allergens are what causes the smooth muscle in the lungs to contract during an asthma attack.  Inflammation due to an allergic response causes the blood vessels to widen and the tissues in the airway wall to swell, which as a result, creates difficulties for the child to breath.

Several investigators have seen as association between asthma and sensitization to another common urban pest, cockroaches, and high exposure among those sensitized has been reported as a risk for asthma medication use and a number of asthma-related hospitalizations (Ginger, et al).

This study has found that mouse allergen was indeed prevalent in inner-city apartments, and the self reported frequency of mice sightings were high (90% saw mice in their kitchen).  Surprisingly, however, high levels of mouse allergens were also present in homes where parents never saw mice.  This goes to show that even if the rodents are unseen they are still around and can still cause health issues.

Mr. Forte strongly believes that an effective way to treat this problem is by issuing new pesticide control campaigns that involve all areas of Harlem, not just a few towns.  The best way to initiate this campaign is by cleaning the streets so fewer rodents are attracted to the area.  This can only occur with a collective effort by all of the inhabitants of Harlem.

Consequentially, the major issue regarding the high childhood asthma rates in Harlem is the socioeconomic difference.  “The income disparity really comes hand-in-hand with the high rates of asthma,” explained Sally Findley, a professor of Population and Family Health and Clinical Sociomedical Sciences at the Mailman School of Public Health at Columbia University.

“In places such as the upper-east side, we don’t see as many cases of asthma because the people have enough money to take care of it.  In Harlem, however, it is much harder for the community to spend money on getting rid of the probable causes of asthma.  They do not have enough resources.”

As a result, less money is used for cleaning the streets, getting rid of mold, and exterminating insects that contain allergens or diseases.  One way to help solve this issue is by educating the public.

Professor Findley, who developed two child health promotion coalitions in NYC, the Start Right and Asthma Basics for Children coalitions, is using her asthma research to test multilevel interventions (provider, school or center, teacher, parent advocate/peer, community health worker) to stimulate improved asthma management for children.

If more money is allocated to the health industry and for health education in these inner-city neighborhoods, the asthma rate for children is bound to go down.

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